Michelle Lynn Clarke, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN2275315 Issued in MA

Practice address

260 Elm St
Suite 105
Somerville, MA 02144-2951

Phone

(617) 666-9577

Fax

(617) 666-3190

NPI assigned

May 31, 2012

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Davis Square Family PracticeGroup PAC ID 1355385196, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mount Auburn Hospital Hospital, Cambridge, MA, CCN 220002

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: michelle.clarke.1@13551.direct.athenahealth.com
• Direct secure messaging: mclarke560298@direct.bilh.masshiway.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Davis Square Family Practice

  • Family Medicine Physician
  • Somerville, MA
  • NPI 1780782409
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mount Auburn Hospital

  • General Acute Care Hospital
  • Cambridge, MA
  • NPI 1689670259
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1338422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457913600000",
    "number": "1104187798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 ELM ST",
            "address_2": "SUITE 105",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021442951",
            "telephone_number": "617-666-9577",
            "fax_number": "617-666-3190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 ELM ST",
            "address_2": "SUITE 105",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021442951",
            "telephone_number": "617-666-9577",
            "fax_number": "617-666-3190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "MICHELLE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-31",
        "last_updated": "2016-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2275315",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "002800301",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• City of Somerville
• City of Somerville
• Jane E Clancy, MD
• Clarity Behavioral Health, LLC
• Elizabeth Clark
• Eleazar Clayton
• Clear Harbor Healing and Empowerment
• Katherine E Clemens
• Jordan Clements
• Sheryl Ann Cliggott, RN

• Family Nurse Practitioner in Somerville, MA
• Providers in Somerville, MA by specialty
• Family Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.